Type 1 and Type 2 – By Liz Buchanan

A lady spotted me checking my blood sugars on the tram and we got talking. When I mentioned ‘insulin’ she jerked visibly as if she’d just been woken up.

‘Oh! You’re a real diabetic, then!’
‘A real diabetic?’
As opposed to what, faking it for conversational purposes?
‘Not one of these – you know, these type two people.’

Ah! Type 2 or – as one of my Type 2 friends calls it – “Class Two” diabetes. At first I thought this was an overreaction on the friend’s part but the longer I am diabetic the more I hear it. Type One – ‘proper, serious, bad, dangerous, difficult’ diabetes. Type Two: ‘not serious’ or even ‘their own fault.’

There was a Facebook reply to my last blog-post to the effect: ‘Who do I talk to about my diabetes? No-one. People aren’t bothered because I’m a type 2’. It made me angry on behalf of the person who had written it (although I’d like to point out that diabetessupport.co.uk is a message board full of people who care passionately about and want to discuss type 2 – and type 1 – diabetes).

So let’s clear all this up. What is the difference?

Well first let’s look at what’s the same. ‘Diabetes’ means that for whatever reason your body cells are not taking enough glucose out of the blood. This means that the glucose builds up in the bloodstream. Over time, high blood glucose can lead to neuropathy (which is often associated with amputated feet or legs), retinopathy (associated, in extremis, with blindness) and nephropathy (that is, irreversible kidney damage).

Does any of that sound ‘not serious’ to you?

‘Type One’ and ‘Type Two’ diabetes were names that some creative spark invented when it was realised that ‘Juvenile-Onset’ (now Type-One) diabetes doesn’t just occur in juveniles: I was twenty-six when I was diagnosed and this is hardly considered to be old these days. People are occasionally diagnosed in their eighties.

So what is Type One? – It is an ‘autoimmune’ disease, meaning that our immune system turns against our own pancreatic cells and prevents them from making insulin. Insulin ‘tells’ our cells to take glucose out of the blood: if we don’t make it, the cells don’t take it. What causes this? Genetics; possibly a viral trigger. What doesn’t cause it? – there is no direct link between Type One and sugar consumption.

Type Two diabetes can also come on at any age: once dubbed ‘mature onset diabetes’ it is becoming increasingly common in youngsters too. Either the body cells become ‘resistant to’ (i.e. start to ignore) insulin, or less insulin is made, or both. What doesn’t cause it? – there is no direct link between Type Two and sugar consumption. Obesity is thought to be a strong risk-factor; there is also a genetic component. Nobody gets diabetes just ‘because they are fat’. There are plenty of very, very fat people who will never get type two diabetes even if they live on fizzy drinks. There are also plenty of type two diabetics who have never been overweight.

However the link between Type Two and lifestyle factors is strong enough that a change in diet and increase in exercise can often bring it under control. So while newly-diagnosed Type Ones go home with a set of Insulin-pens to start injecting, many newly-diagnosed Type Twos follow a new eating plan and exercise. Anyone who has ever tried to completely and forever overhaul their lifestyle will realise that this is a colossal challenge, particularly when you are ill: to presume that one group require support and the other don’t is purely and simply wrong.

If diet and exercise changes do not do the trick, Type 2s often take tablets to lower their blood glucose or carb-count and inject insulin, just like a Type One. Going back to the lady on the tram, I wonder whether she would consider them ‘real’ diabetics now?

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ik ben nederlands en ik heb ook diabetes type 1
het is niet fijn als je diabetes hebt met al dat prikken enzo.
dus ik wil alle mensen met diabetes type 1 aanraden om een pomp te nemen.
een pomp is namelijk heel handig met alle techniese snufjes die eraan zitten dus als je nederlands bent en je leest dit neem de pomp!!!!!!!

I am so glad you’ve written this – it seems not many people take T2 seriously as it does sound second class, being a 2! They seem to think, as I did before being diagnosed and learning the facts, that is a milder, less threatening version of T1. I think more publicity is needed about T2. My cousin’s husband has just been diagnosed and he said that he suspects many people are undiagnosed – he got that right! We then went out for lunch and he ordered a honeycomb blizzard for dessert, there was sugar free cheesecake on the menu – I don’t think he has taken diabetes on board! Also. People need to understand that T2 is not necessarily caused by lifestyle choice – it really isn’t! At a life time weight of 8-9 stone at 5’5′, far from sedentary and trying to eat healthily my T2 seems to be genetic. So I say ‘Spread the word of the truth about T2’!

Needed to say,while neither illness is ok, they are different-how many hypos and diabetic comas do type 2s have? Control is the key and many type 2s have been making poor lifestyle choices, if any diabetic continues to make poor choices the results are terrifying. This blog seems to be an angry kneejerk reaction while not considering that these really are 2 illnesses that both need support.